Impact of reducing colistin use on colistin resistance in humans and poultry in Indonesia (COINCIDE)




Antimicrobials are drugs that help cure people and animals from infections with bacteria. The slogan: ‘the more you use, the faster you lose’ is definitely applicable for antimicrobials. When you use antimicrobials, more bacteria become resistant, meaning that an infection can no longer be treated. This is a worldwide challenge for the treatment of diseases in animals and humans.

The World Health Organization (WHO), like many other organizations, are advocating for reduction of use of antimicrobials when they are not needed. The COINCIDE-project explores what will happen when the use of colistin in animals is banned in Indonesia. Colistin is a specific antimicrobial that is used as last resort in humans if nothing else works, resistance against this antimicrobial means that resistant disease causing bacteria will have free reign.

In animals, colistin has been banned in 2020 and a group of human doctors, veterinarians, anthropologists and DNA researchers will look if less bacteria become resistant. We also want to reduce the colistin use in humans, as it is suspected to be used in humans without good reasons. We will work with farmers and their veterinarians, but also with people in the community and doctors and pharmacies to find out why they are still using colistin and if they can do without. The outcome of the project will help governments, farmers, veterinarians, human doctors, and everybody who really needs colistin, to safeguard this antimicrobial for use only when we cannot do without.

Project partners

  • Anis Karuniawati, Universitas Indonesia, Indonesia (Coordinator)
  • Juliëtte Severin, Erasmus MC University Medical Center Rotterdam, Netherlands
  • Jaap Wagenaar, Utrecht University, Faculty of Veterinary Medicine, Netherlands
  • Sunandar Sunandar, Center for Indonesian Veterinary Analytical Studies, Indonesia
  • Herman Barkema, University of Calgary, Canada
  • Koen Peeters, Institute of Tropical Medicine, Belgium
  • Imron Suandy, Directorate of Veterinary Public Health, DG of Livestock and Animal Health Services, MoA-Indonesia, Indonesia